CMS HPMS Memo, Part D Payment for Drugs for Beneficiaries Enrolled in Medicare Hospice (July 18, 2014), § Effective date of the revised guidance

This guidance will be effective as of the date of issuance. However, we recognize sponsors will

require some time to implement the changes to effectuate the guidance. Therefore, although we

strongly encourage sponsors to implement the guidance as soon as possible, our expectation is

that all sponsors will have implemented it by October 1, 2014. Additionally, we recognize that

coverage determinations will be pending for some previously rejected claims for drugs other than

those in the four categories. Since these claims should no longer to be subject to hospice PA

reject edits, the drugs should be considered covered under the Part D benefit without the sponsor

obtaining documentation regarding the relatedness of the drug.

In closing, we will coordinate with stakeholders to provide any additional clarification necessary.

Questions should continue to be sent to the CMS Part D policy mailbox at

PARTDPOLICY@cms.hhs.gov.

Addendum: Applicable Portions of the March 10, 2014 Guidance

(Edited as necessary to incorporate updated guidance issued July 18, 2014)